N.J. Physicians Apply for Right to Unionize

TRENTON, N.J. — Angry over what they call intrusive control by health maintenance organizations, hundreds of New Jersey doctors Monday became the first private-practice physicians in the country to apply for the right to unionize.

The doctors asked the National Labor Relations Board to appoint United Food and Commercial Workers Local 56 to represent them in collective bargaining with AmeriHealth HMO, a subsidiary of Philadelphia-based Independence Blue Cross.

Union officials contend the HMO is the de facto employer of 400 to 500 family doctors and specialists in two counties because it supervises them, sets working conditions, makes unannounced inspections and even limits the care they may give patients. AmeriHealth and other HMOs, they argue, cut costs at the expense of patients.

"As bad as it is for the physicians, it's ultimately much worse for the patients," because HMOS often delay or deny crucial patient care, said Dr. Arthur Nahas, a family practitioner.

Dr. Richard Gilfillan, AmeriHealth's general manager for New Jersey, said the physicians in question "are independent medical practitioners with whom we, and other insurers, contract and are not employees." Therefore, he said, "the National Labor Relations Act does not apply to them."

Independence Blue Cross spokesman Jim Panyard had no comment on the union drive.

Salaried doctors employed by government-run hospitals or health agencies are already unionizing in some areas. But up to now, privately employed physicians have been barred from collective bargaining, because they are considered independent contractors and cannot organize to set fees or policies.

The doctors want the union to bargain with HMOs on matters such as the determination of when patients get specialized or particularly expensive care, reimbursement rates and paperwork requirements.